title: Changing profile of organisms causing scleral buckle infections: a clinico-microbiological case series.
abstract: OBJECTIVE
  To study the microbiological spectrum and in vitro susceptibility of bacterial isolates from explanted scleral buckles and to correlate clinical presentation to the causative agent.
  
  
  METHODS
  Medical records of patients who underwent buckle explantation from July 2007 to May 2012 were reviewed retrospectively. Clinical features and microbiological profile were noted and correlated.
  
  
  RESULTS
  Twenty of 24 buckles (83.33%) from 24 patients grew 21 isolates. Isolates included 6 acid-fast bacilli (28.57%; atypical mycobacteria = 5, Nocardia asteroides = 1), 5 gram-positive bacilli (23.8%; Corynebacterium spp. = 4, Bacillus sp. = 1), 4 gram-positive cocci (19.0%; Staphylococcus spp. = 4), 2 gram-negative bacilli (9.5%; Pseudomonas aeruginosa = 2), and 4 fungi (19.0%; Aspergillus spp. = 3, Paecilomyces sp. = 1). Acid-fast bacilli and gram-negative bacilli were sensitive to amikacin and gram-positive bacilli and gram-positive cocci to vancomycin. Buckle exposure within 2 years of primary surgery tended to be noninfective (P = 0.06). Fungal or mycobacterial infections were more symptomatic than those with Corynebacterium species. Results of microscopic examination of conjunctival swab in 5 of 7 eyes (71.4%) were consistent with culture of conjunctival swab and explanted buckles.
  
  
  CONCLUSIONS
  Clinical features and microscopic examination of conjunctival swab may give a lead toward the causative organism in suspected buckle infections. Based on these leads, vancomycin and amikacin may be used as the initial empirical therapy.
authors.affiliation: *Retina Vitreous Service, and †Ocular Microbiology Service, L V Prasad Eye Institute, Bhubaneswar, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Mohan
authors.forename: Sarita
authors.initials: S
authors.lastname: Kar
authors.forename: Tapas Ranjan
authors.initials: TR
authors.lastname: Padhi
authors.forename: Soumyava
authors.initials: S
authors.lastname: Basu
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.forename: Tara Prasad
authors.initials: TP
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000583:Amikacin / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D020878:Device Removal; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005658:Fungi / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012163:Retinal Detachment / Q000601:surgery; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000009:adverse effects; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D014640:Vancomycin; D000583:Amikacin